Influence of preoperative chemotherapy on postoperative infectious complications after hepatic resection for colorectal liver metastases

Abstract

This study investigated the influence of preoperative chemotherapy on postoperative infectious complication (PIC) after hepatic resection for colorectal liver metastases. One hundred and fifty two patients who underwent hepatic resection without synchronous primary tumor resection between April 2011 and December 2015 were classified into two groups according to the presence (PC group: n=105)or absence (NPC group: n=47)of preoperative chemotherapy. Perioperative outcomes in the two groups were retrospectively compared. More patients of PC group suffered from preoperative hypoalbuminemia and severe surgical stress, estimated by the extent of liver resection, operative time and blood loss, compared to those of NPC group. The incidence of PIC was significantly higher in patients of PC group than in those of NPC group (32% vs. 15%, P<0.05). Multivariate analysis revealed that diabetes mellitus, sinusoidal obstruction syndrome grade of nontumor-bearing liver, biliary fistula and preoperative chemotherapy were associated with the development of PICs. The increased risk of PICs was observed particularly among patients who had received 16 weeks or longer duration of chemotherapy. These results suggest that shorter duration chemotherapy is preferable in terms of risk reduction for PIC, and careful postoperative management is needed especially for those exposed to prolonged chemotherapy.